What are the causes of Cancer-related Fatigue?
In the previous article Cancer and fatigue, an introduction we saw what is cancer-related fatigue, and how it differs from healthy fatigue.To understand Cancer-related fatigue, we need to better understand the underlying causes and various other factors which can be and have been associated with it.Fatigue, like pain, is a subjective feeling and its intensity varies from person to person.Hence, this makes it difficult, if not impossible, to measure its intensity and know its characteristics objectively.
The causes and factors mentioned here will strongly vary, and will depend upon variables like:
- Type of cancer
- Stage of cancer
- Treatment protocol
- Other medications
- Other underlying diseases
- Level of activity before and after the disease
- Fitness level before the disease, etc
The causes of fatigue can be as following :
1. Cancer:
The disease itself is known to cause fatigue in individuals with advanced stage who are not taking any treatment for the same. A very well known symptom of cancer is rapid unexplained weight- loss. This could be the primary reason for constant fatigue as it leads to development of anorexia, cachexia or asthenia. This leads to over all physical de-conditioning of the person. The tumor when growing, may lead to hormonal imbalance too.Depending on the type of cancer and the invasion of tumor to other parts/ metastasis, there can also be involvement of lungs, heart and neuro-muscular components.All these changes in the body can lead to development of fatigue, which is mild in character.
2. Cancer treatment:
The major treatment modalities include Surgery, Chemotherapy , Radiotherapy, Biotherapy, etc.
Surgery-
This is done for diagnosis or treatment purpose.The postoperative fatigue exists even in non-cancer patients who have undergone a surgery.
Characteristics-This type of fatigue however diminishes with time but may be reinforced by fatigue due to other treatment modalities.
Chemotherapy-
This is a major contributor for generating fatigue. All the chemotherapy agents contain either the products of cell death or cell damage, and it does not spare even the healthy cells of the body, hence affecting the healthy tissues and organs too.
Characteristics-Fatigue is seen to be at its peak during the chemotherapy cycle and gradually reduces after the cycle, but never disappears totally.
Radiotherapy-
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Fatigue is the most common side effect of radiation therapy.
Characteristics-This may seem to be increasing after the treatment is finished and remains for quite sometime.
Biotherapy-These agents are directly associated with cytokines, which is a known contributor towards fatigue.The intensity of fatigue varies with the dosage of the bio-therapeutic agents.
3. Psychological stress/ Depression:
The diagnosis itself can be very distressing for any individual who was leading a very normal life prior to that.This will definitely cause a lot of changes in a person's life all of a sudden which is very difficult to cope up with.Undergoing all the tests, procedures and treatments also takes its toll on the body and mind of a person.All this leads to a vicious cycle of depression and stress which results into its physical manifestation as fatigue.This is again very relative and subjective.Individuals who deal with the diagnosis in a better manner might experience lesser fatigue than the ones who can't.
4. Anemia:
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Anemia is nothing but reduced Hemoglobin in the red blood cells, which is a carrier of oxygen.Anemia can be caused by Cancer and its treatments too. Anemia is a single most prevalent contributor to symptoms in cancer patients.Prevalence of anemia is high and it is closely associated with fatigue.
5. Nutrition deficiency:
In healthy individuals, fatigue occurs if the energy requirements of the body are more than the available energy sources within the body.
In individuals with cancer, there can be various causes of nutrition deficiency like
Decreased energy intake due to nausea, vomiting, etc
Increased demand for energy due to growth of tumor.
6. Other medications:
Medications other than chemotherapeutic agents like
Opioids, given to deal cancer pain can be a major contributor due to its sedative properties.
Tricyclic antidepressants, analgesics,antiemetics,antihistamines,beta blockers,etc also may lead to perception of fatigue.
7. Poor sleep hygiene:
Disturbance in the sleep-wake cycle is a common finding.For eg, increased day-time sleep and reduced night-time sleep. This leads to a very non-restorative kind of sleep, and hence leads to higher perception of fatigue.
8. Pain:
A constant experience of pain must be very tiring. Pain is very much directly related to fatigue.
Other factors:
There can be many other factors which lead to cancer- related fatigue like-
underlying infection
dehydration
inactivity
cognitive impairments,etc.
See Cancer Fatigue Symptoms for more information.
Also read
What are the symptoms of Cancer-related fatigue?
How to diagnose Cancer-related Fatigue?
How to evaluate fatigue?
How to evaluate fatigue using multi-dimensional tools?
Causes of Cancer
The disease itself is known to cause fatigue in individuals with advanced stage who are not taking any treatment for the same. A very well known symptom of cancer is rapid unexplained weight- loss. This could be the primary reason for constant fatigue as it leads to development of anorexia, cachexia or asthenia. This leads to over all physical de-conditioning of the person. The tumor when growing, may lead to hormonal imbalance too.Depending on the type of cancer and the invasion of tumor to other parts/ metastasis, there can also be involvement of lungs, heart and neuro-muscular components.All these changes in the body can lead to development of fatigue, which is mild in character.
2. Cancer treatment:
The major treatment modalities include Surgery, Chemotherapy , Radiotherapy, Biotherapy, etc.
Surgery-
This is done for diagnosis or treatment purpose.The postoperative fatigue exists even in non-cancer patients who have undergone a surgery.
Characteristics-This type of fatigue however diminishes with time but may be reinforced by fatigue due to other treatment modalities.
Chemotherapy-
Characteristics-Fatigue is seen to be at its peak during the chemotherapy cycle and gradually reduces after the cycle, but never disappears totally.
Radiotherapy-
.jpg "radiotherapy")
Characteristics-This may seem to be increasing after the treatment is finished and remains for quite sometime.
Biotherapy-These agents are directly associated with cytokines, which is a known contributor towards fatigue.The intensity of fatigue varies with the dosage of the bio-therapeutic agents.
3. Psychological stress/ Depression:
The diagnosis itself can be very distressing for any individual who was leading a very normal life prior to that.This will definitely cause a lot of changes in a person's life all of a sudden which is very difficult to cope up with.Undergoing all the tests, procedures and treatments also takes its toll on the body and mind of a person.All this leads to a vicious cycle of depression and stress which results into its physical manifestation as fatigue.This is again very relative and subjective.Individuals who deal with the diagnosis in a better manner might experience lesser fatigue than the ones who can't.
4. Anemia:
.jpg "anemia")
Anemia is nothing but reduced Hemoglobin in the red blood cells, which is a carrier of oxygen.Anemia can be caused by Cancer and its treatments too. Anemia is a single most prevalent contributor to symptoms in cancer patients.Prevalence of anemia is high and it is closely associated with fatigue.
5. Nutrition deficiency:
In healthy individuals, fatigue occurs if the energy requirements of the body are more than the available energy sources within the body.
In individuals with cancer, there can be various causes of nutrition deficiency like
Decreased energy intake due to nausea, vomiting, etc
Increased demand for energy due to growth of tumor.
6. Other medications:
Medications other than chemotherapeutic agents like
Opioids, given to deal cancer pain can be a major contributor due to its sedative properties.
Tricyclic antidepressants, analgesics,antiemetics,antihistamines,beta blockers,etc also may lead to perception of fatigue.
7. Poor sleep hygiene:
Disturbance in the sleep-wake cycle is a common finding.For eg, increased day-time sleep and reduced night-time sleep. This leads to a very non-restorative kind of sleep, and hence leads to higher perception of fatigue.
8. Pain:
A constant experience of pain must be very tiring. Pain is very much directly related to fatigue.
Other factors:
There can be many other factors which lead to cancer- related fatigue like-
underlying infection
dehydration
inactivity
cognitive impairments,etc.
See Cancer Fatigue Symptoms for more information.
Also read
What are the symptoms of Cancer-related fatigue?
How to diagnose Cancer-related Fatigue?
How to evaluate fatigue?
How to evaluate fatigue using multi-dimensional tools?
Causes of Cancer
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